Counseling Women Who Have Terminated a Pregnancy Due to Fetal Anomaly (TOPFA): The ACCEPT Model

Abstract

Women who have terminated a pregnancy due to fetal anomaly (TOPFA) may experience disenfranchised grief, societal stigmatization, and lack of support. A history of legislative attempts to criminalize TOPFA providers, public misunderstanding, and poor healthcare experiences may create reluctance in women to seek face-to-face counseling. While recent publications have assessed the grief reactions and help-seeking of women who TOPFA, few have provided an informed approach to therapeutic intervention for clinical social workers. This article attempts to provide a practice model through a composite case study utilizing the proposed ACCEPT model. The ACCEPT model incorporates elements of modern grief theory and consists of acknowledging disenfranchised grief, connecting emotions to the loss, continuing bonds, exploring distortions, practicing new skills, and telling the story. Implications and recommendations for social work engagement, awareness, and therapeutic support of this population are also provided.